Posted on 06/20/2002 10:57:56 PM PDT by JohnHuang2
TLANTA, June 20 — A panel of specialists advising the federal government on smallpox vaccinations unanimously rejected a proposal today to offer vaccines to every American. Instead, the panel recommended immunizing only the estimated 15,000 health care and law enforcement workers who would be most likely to respond to a biological attack and come in contact with victims.
In rejecting the idea of starting mass vaccinations for the first time since routine immunization was halted in 1972, the panel said the risks of complications from the vaccine outweighed its benefits in the absence of any known case or confirmed threat of a smallpox attack.
In the event of an attack, the panel said, the government should follow the health care strategy known as ring vaccination, in which victims are isolated and those with whom they had direct contact are vaccinated. In that way, the panel said, state and local health departments "would be able, if necessary, to expand immunization to additional groups, up to and including their entire population, in a timely manner."
After the anthrax attacks last fall, the government ordered millions of doses of smallpox vaccine and the Centers for Disease Control and Prevention asked a 14-member panel to determine whether changes were needed in current recommendations, which limit smallpox vaccine to scientists working with smallpox and related viruses in a laboratory.
The new recommendations from the panel, the Advisory Committee on Immunization Practices, will be sent to the centers' acting director, Dr. David Fleming, and then forwarded to Tommy G. Thompson, the secretary of health and human services.
Dr. Dixie E. Snider, an official at the centers who is executive secretary of the panel, said that in the past its recommendations had not been rejected, though the language was modified in a few cases.
Mr. Thompson said he would review the recommendation with experts "as the administration works toward a policy on the smallpox vaccine."
"We plan to move as expeditiously as possible," he said, "so that we have a policy in place as more vaccine becomes available later this year." The government expects to have enough vaccine to protect every American by early next year.
Charles Pena, a defense policy analyst at the Cato Institute, told The Associated Press that the panel should have chosen mass inoculation. He said those at risk for side effects could choose not to get shots.
"That's the government deciding who gets to live," Mr. Pena said. "They're willing to allow some number of the public to be exposed to the virus if it's used as a bioterror weapon."
Of all the vaccines, smallpox is among the most dangerous. The virus from which it is derived — a cousin of the smallpox virus — can spread from a recipient and can cause life-threatening complications, especially in people with impaired immune systems.
During the two days of the meeting, panel members said their intent was to allow flexibility in administering their recommendations. The panel said it expected to review its recommendations "periodically, or more urgently if necessary," to consider new developments related to smallpox, the vaccine, the risk of an attack and other factors.
Speaking at a news conference, Dr. John F. Modlin, the panel chairman from Dartmouth Medical Schools, and Dr. Julie L. Gerberding, the acting deputy director of the disease control centers, said it would take several months to carry out the recommendations if they became government policy. Dr. Modlin estimated that 10,000 to 20,000 people would be vaccinated under the plan, but said the earliest anybody could receive it would be in the fall.
One reason, said Dr. Natalie J. Smith, an official of the California State Health Department and a panel member, is that her colleagues there and in other states need time to work out the logistics.
While the panel encouraged the nation's 5,000 hospitals to develop plans to respond to a smallpox case, it did not recommend vaccinating all 100,000 or so hospital workers. That would cause logistical problems, the panel said, and would unnecessarily vaccinate many people unlikely to come in contact with any victims.
Today's recommendations allow government officials in each state and territory to designate two sets of selected health care workers to receive smallpox vaccinations. The workers would be part of teams designated to investigate the initial cases in a smallpox outbreak and to directly care for victims.
The number of such teams would vary with the population and geography of each state and would be coordinated with federal, state and local bioterrorism plans. Each state should form at least one such team, the panel said.
The investigative team would include a medical team leader, a public health adviser, medical epidemiologists, disease investigators, diagnostic laboratory scientists, nurses, vaccinators and security and law enforcement workers, the panel said. Such teams would include doctors and nurses who would assist in determining whether suspect cases were indeed smallpox.
Vaccines would also be provided to selected health care workers at hospitals designated by government officials in each state. Each hospital would determine which workers to vaccinate and to train to care for smallpox cases, the panel said.
Dr. Stanley Plotkin, a vaccine expert who is not a member of the panel, said in an interview that the ring vaccination plan would protect the country against large numbers of cases if 10 or so infected bioterrorists spread the virus.
But he added that if terrorists used an aerosol to expose thousands of Americans, the plan would not prevent a significant number of deaths.
Dr. Plotkin urged President Bush to ask President Vladimir V. Putin of Russia whether officials there could account for all their stocks of smallpox assembled during the cold war.
Dear XXX:
Thank you for contacting me concerning America's preparation for a bioterrorism attack. I appreciate hearing from you on this matter.
As you may know, the federal government continues to make preparations for a bioterrorism attack. Of greatest concern has been the possible exposure of the American public to anthrax and smallpox. Anthrax is not contagious, and only the inhalation form of anthrax is likely fatal. According to Dr. Jeffrey Koplan, Director of the Centers for Disease Control and Prevention (CDC), infection can be prevented with antibiotic treatment of persons exposed to anthrax. Therefore, antibiotics would be used to treat any future anthrax cases in the civilian population. The United States currently has enough antibiotics stockpiled to treat 2 million persons exposed to anthrax. The CDC is also considering quicker anthrax detection tests.
The federal government is also evaluating additional federal, state, and local preparation for a smallpox attack. The CDC has developed an interim smallpox response plan. The CDC plan calls for rings of personal contacts, such as family members and co-workers, to be identified and then vaccinated and monitored. This strategy, known as ring vaccination, is credited with helping to wipe out smallpox in the late 1970s and, according to the CDC, is still the most efficient approach today.
In response to the recent terrorism attacks, the Department of Health and Human Services (HHS) is implementing measures to boost the smallpox vaccine supply to 286 million doses by the end of 2002, which would be enough to vaccinate every U.S. citizen. Additionally, the National Institutes of Allergy and Infectious Diseases (part of the National Institutes of Health) is currently studying the possible dilution of our current vaccine supply, which would expand our current supply to at least 77 million doses.
The United States Postal Service has also leased the use of two irradiation machines to sterilize targeted mail, including all mail addressed to congressional offices, federal agencies and the White House. The USPS also purchased eight irradiation machines, yet to be installed, with $175 million appropriated by the Emergency Supplemental Appropriations, (H.R. 2888), which became law on September 18, 2001 (P.L. 107-38).
On December 4, 2001, Senator Bill Frist introduced the Bioterrorism Preparedness Act, S. 1765. I am a cosponsor of this bill. This bill would provide $3.2 billion in fiscal year 2002 to bolster our preparedness for a bioterrorism attack. The funding includes $1.1 billion to improve state and local public health system responses; $643 million to improve the National Pharmaceutical Stockpile which includes antibiotics for diseases like anthrax, as well as $509 million to increase the supply of the smallpox vaccine; $500 million to protect food supplies and crops; and $120 million for CDC to improve its disaster response medical system and laboratories and create a national laboratory network. A companion bill, H.R. 3448 was introduced and passed by the House. The Senate unanimously passed H.R. 3448 on December 20, 2001, with S. 1765 inserted as an amendment in the nature of a substitute. The bill is currently pending action by a conference committee between the House and Senate.
Congress provided additional funding with the passage of the Department of Defense Appropriations bill for fiscal year 2002, H.R. 3338. This bill became law on January 10, 2002 (P.L. 107-117). Funding for bioterrorism in this bill totals $2.5 billion, including $1 billion for states to help hospitals and local health departments cope with the threat of attacks, $500 million for the accelerated production and development of anthrax vaccines, and nearly $650 million for antibiotics and other medicines to combat biotoxins.
As a result of this new federal funding, Washington state will receive more than $20.5 million, about $18 million from the CDC and about $2.5 million from the Health Resources and Services Administration (HRSA). The Washington State Department of Health has targeted this funding for expanded disease surveillance, enhanced public information and communication systems, and more resources for local health departments.
To enable the USPS to better prepare for a bioterrorism attack, this bill provided the USPS with $500 million. On March 7, 2002, the USPS submitted an emergency preparedness plan to Congress for the use of this funding, including plans to deploy equipment to prevent the cross-contamination of mail, such as filtration systems that detect biohazards and vacuum machines to prevent the dispersion of spores from envelopes.
Thank you for contacting me concerning this important issue. Please be assured that if the Senate has the opportunity to consider this issue during the 107th Congress I will keep your views in mind.
Sincerely, Maria Cantwell, United States Senator
This letter reads like the worst kind of socialist "big brother" double-talk. Ring vaccination was used in third world countries. We vaccinated everybody possible here. That is what REALLY wiped out smallpox. The CDC is making the decision of who lives and who dies. We cannot let this kind of elitism stand.
Hospitals around the country are refusing to cooperate with the CDCs demand that "isolation hospitals" for dealing with contagious patients be designated. They aren't stupid. Smallpox virus is airborne and virulent. Containing it is extremely difficult and definitely not profitable.
FOR THE SAFETEY OF OUR FAMILIES -- THE MAJORITY OF AMERICANS MUST BE VACCINATED.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.